Common Neurologic Patient Care Problems: Chapter 21, The Neurologic System

Question 1 of 9

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Which information would the nurse include when teaching family members about how to provide care for a patient with aphasia?

• • “Speak clearly and loudly.”There is no need to speak loudly unless the aphasic patient is hard of hearing.
• • “Avoid speaking to the patient; speak to the interpreter.”The nurse would speak to the patient, not about the patient; the nurse may also need to speak to an interpreter.
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  • “Avoid speaking to the patient as if he or she is mentally incompetent.”It is important to avoid speaking to an aphasic patient as if he or she is mentally incompetent.
• • “If something needs to be repeated, restate it in a different way to help comprehension.”If something needs repeating, it is important for the nurse to repeat the statement in exactly the same way.

Question 2 of 9

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When assigned to a neurologic nursing unit, which common problem would the nurse anticipate encountering while providing care for patients with neurologic concerns? Select all that apply. One, some, or all responses may be correct.

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  • AphasiaAphasia is one common neurologic patient care problem.
• • AsystoleAsystole is a cardiac problem that occurs when there ceases to be any cardiac electrical activity. This is not necessarily a common problem when caring for a patient with a neurologic condition.
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  • ConfusionConfusion is one common neurologic patient care problem.
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  • DysphagiaDysphagia, or trouble swallowing, is one common neurologic patient care problem.
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  • Impaired mobilityImpaired mobility is one common neurologic patient care problem.

Question 3 of 9

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What term would the nurse use to document a patient who is suffering from one-sided weakness?

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  • HemiparesisHemiparesis is the term for one-sided weakness.
• • TetraplegiaTetraplegia occurs when a person has four limbs paralyzed.
• • HemiplegiaHemiplegia is paralysis and loss of sensation on one side of the body.
• • ParaplegiaParaplegia is paralysis of the lower extremities.

Question 4 of 9

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Which statement made by the nurse regarding bladder reconditioning requires further education?

• • “The trial should be evaluated after 6 weeks to see if it has been successful.”This is an accurate statement. A full 6 weeks of training is essential before evaluating whether it has been successful.
• • “The reconditioning generally beings with a 2-hour schedule for toileting.”This is the correct schedule for start with, as it trains the patient to attempt to empty the bladder every 2 hours.
• • “One of the purposes of a bladder reconditioning program is to prevent calculi from developing.”The purposes of a bladder reconditioning program are to prevent urinary complications, such as calculi and infections.
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  • “Patients with neurogenic bladder must be trained how to stop voiding.”Patients with a neurogenic bladder are not aware of the need to void, so they need to be trained in techniques to initiate voiding.

Question 5 of 9

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What is the name of the technique used to help empty the bladder?

• • Valsalva maneuverThe Valsalva maneuver is a breathing method to help slow the heart rate down.
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  • Crede maneuverThe Crede maneuver teaches the patient to place their hand over the bladder area and apply pressure down toward the suprapubic area to facilitate emptying the bladder.
• • Epley maneuverThe Epley maneuver is a series of head movements to help alleviate benign positional vertigo.
• • Romberg maneuverThe Romberg maneuver is used to test balance.

Question 6 of 9

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If a patient is having trouble with bowel incontinence at specific times after eating, what intervention might the nurse suggest?

• • Reducing the amount of fiber in the dietIncreasing the amount of fiber in the diet is helpful to patients with constipation and incontinence.
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  • Trying to toilet 30 minutes soonerThis would be the appropriate intervention to help with bowel training.
• • Lowering the toilet seat to a move comfortable levelRaising the toilet seat and adding a step stool can provide comfort and allow the patient to relax so that evacuation can occur naturally.
• • Reducing physical activity until peristalsis has improvedAn exercise program, within the patient’s ability, along with increasing fiber and fluid intake help to alleviate both constipation and incontinence.

Question 7 of 9

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Which pain intervention would be appropriate for a patient experiencing pain associated with a neurologic disorder? Select all that apply. One, some, or all responses may be correct.

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  • Use massage therapy.Using nonpharmacologic methods for pain control can be very helpful.
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  • Develop a trusting relationship.A trusting relationship is necessary for teaching to be assimilated.
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  • Teach the patient distraction techniques.Teaching the patient about the benefits of distracting themselves from the pain is an important aspect of pain control.
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  • Administer antidepressant medication, as ordered.Depression often occurs as a result of the pain and lack of sleep. The combination of an antidepressant and pain medication can help control chronic pain.
• • Avoid pharmacologic therapy if possible.Pharmacologic therapy can be very beneficial, and our goal should be to make the patient as comfortable as possible so they have the best quality of life.

Question 8 of 9

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Which of the following statements made by the nurse indicates a need for further education regarding confusion in a patient with a head-related injury?

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  • “Patients should be restrained if they are a risk for themselves.”Even though the patients can become combative because of their confusion, it is not advised to restrain them as this can frighten the patient and worsen their symptoms.
• • “Patients may become combative as their intracranial pressure (ICP) rises.”Patients who experience confusion as a result of a head injury can often become combative as their ICP rises.
• • “Stimuli entering the brain can be frightening to the patient.”Stimuli entering the brain are frightening and threatening as their thought processes are fractured.
• • “Acute delirium can occur as a result of a metabolic imbalance.”Acute delirium can occur as a result of fevers and metabolic imbalances.

Question 9 of 9

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Which statement regarding altered family functioning is accurate?

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  • Family members may feel powerless to help their loved one.Family members may feel powerless, angry, guilty, and ambivalent toward the patient.
• • Only the patient should be provided teaching about their disorder.Family members must be included the education regarding the disease, remissions, exacerbations, and self-care measures.
• • The patient is the only family member who needs to adjust to the condition.Though this is important, everyone needs time to adjust to the situation, not just the patient.
• • The patient and family rarely benefit from support group referrals.Referrals to counseling and support groups are very beneficial.